Perioperative medicine & outcomes
Incidence of preoperative instrumental activities of daily living (IADL) dependence and adverse outcomes in older surgical patients: A systematic review and meta-analysis
Authors' conclusion
There is a high incidence of IADL dependence in older surgical patients undergoing non-cardiac and cardiac surgery. Preoperative IADL dependence was associated with a two-fold risk of postoperative delirium.
Study context
- Population
- Patients aged ≥60 years undergoing surgery with preoperative IADL assessed by the Lawton IADL Scale; databases searched 1969 to April 2022
- Participants
- 5,690 patients · 21 studies
- Comparison
- Preoperative IADL dependence vs no IADL dependence
- Outcome
- Pooled incidence of preoperative IADL dependency
Pooled result
As reported in the abstract
Pooled incidence of preoperative IADL dependence
Non-cardiac surgery (2909 patients), pooled incidence
37%
95% CI 26.0%, 48.0%
Cardiac surgery (1074 patients), pooled incidence
53%
95% CI 24.0%, 82.0%
Further pooled results
| Outcome | IADL dependence | No IADL dependence | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| PODI2: 0% | 44.9% | 24.4 | 2.26 (1.42–3.59) | P = 0.0005 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Incidence of preoperative instrumental activities of daily living (IADL) dependence and adverse outcomes in older surgical patients: A systematic review and meta-analysis. J Clin Anesth. Published 19 May 2023. doi:10.
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